Smartphones in Healthcare: Does Everybody Really Need One?

October, 2018

Earlier this year, KLAS issued its first report about smartphone usage in healthcare, titled Clinical Mobility 2018 – Leveraging a Smartphone Strategy. It offers a lot of valuable information to help hospitals decide on which smartphones to deploy.

The report identified three different deployment models for smartphones:

• Shared-use
• Bring your own device (BYOD)
• Personal use, also called “choose your own device” (CYOD)

It also provides excellent guidance for choosing a smartphone that works well for each model, using data collected from more than 100 hospitals. Download a free copy of the report here.

Before you go down the path of deciding which smartphones to deploy, I recommend you ask two questions. One: “Does everyone need a smartphone?” And two: “How do I determine that?” I strongly believe that you need to start by thinking about end users and the IT services they need.

Understanding Users’ Needs: A Service-Oriented Mindset

I was talking with a long-time Vocera Badge customer recently. He said, “We’re looking to expand our use of the Vocera Platform, but the Badge can’t meet the needs of our new groups of users.”

This is the kind of customer I can help most effectively because he is thinking about their different types of end users and the technology services they need. He already understands that some users need more than the voice calling, messaging, alerts and alarms, and hands-free services the Vocera Badge has been delivering for years.

By contrast, another customer started a similar conversation by saying, “Well, everyone needs to have a smartphone.” I asked her to help me understand why she thought so. Her explanation didn’t offer much insight, which indicated to me that this customer was thinking about devices and not services.

Voice calling is a service. Messaging is a service. So are alert and alarm notification, accessing patient records, med administration, and positive patient identification (PPID) – just to name a few. Does everyone need all of these services? Maybe, maybe not. Do some users need to have their hands free or can they use one hand to hold a smartphone? In that sense, hands-free communication is also a service.

Understand which IT services end users need before thinking about the device capabilities that will meet those needs. When you understand what users need, you may realize that a smartphone is not always the right device to support those needs.

When to Choose a Vocera Badge

Choosing between a Badge and a smartphone is pretty straightforward. If users need to be hands-free, or if they only need voice calling, messaging, and alert and alarm notifications, then give them a Badge. If they need more services than that, and don’t need to be hands-free, then give them a smartphone.

I frequently talk about the “Big Four” areas where clinicians and staff are most likely to need hands-free devices: surgery, emergency, labor and delivery, and ICUs.

Choosing a Smartphone Strategy: Three Models

Once you decide you need smartphones, the next questions become:

• Which kinds of smartphones do we need?
• Should we allow clinicians to use their personal smartphones on our network?
• Do we need company-owned, company-provided phones?
• Should we provide personal smartphones to some users?

The KLAS report examines each of these models in depth.

The shared use model is mainly oriented toward shift workers. The hospital buys phones and workers use them in the facility during their shift. At the end of their shift, they give them to the people working the next shift. These phones are designed to be used 24/7, most often with removable batteries. They are typically ruggedized for the hospital environment, including healthcare-grade plastics that will not deteriorate when wiped with harsh chemicals needed for infection control.

Shared use phones are the easiest for the hospital to control and maintain because the entire device, OS, and set of applications is owned and managed by the hospital. Also, the phone does not leave the facility. They are also the easiest to manage with and Enterprise Mobility Management (EMM) tool because they are always connected to the enterprise network.

In a bring your own device (BYOD) model, end users bring their own personal smartphones to the workplace. They use them to access the enterprise network and run enterprise applications. They may also run personal applications. The most common users of BYOD models are physicians, especially those not employed by the hospital.

The biggest concerns for a hospital that allows BYOD phones are security and compatibility. The hospital has much less control over what the end user is doing on his or her personal phone and whether the phone has adequate security. Also, BYOD models result in a wider variety of smartphones being used in the environment, making support more challenging. For example, many older smartphones do not have wireless chipsets that support roaming while using voice over Wi-Fi. Users of older devices are more likely to have calls dropped if they are moving through the facility.

The KLAS report has great suggestions for how to mitigate these and other concerns associated with BYOD.

In a choose your own device (CYOD) model, the hospital purchases a personal smartphone for each user. (KLAS calls this model personal use.) One hospital system I know of buys iPhones with cellular plans for all of their employed physicians.

The benefit of the CYOD model over the BYOD model is that it allows the IT organization more control of the device and the IT environment. CYOD is easier to support than BYOD because CYOD involves standardizing on one phone or a small number of phones. IT knows, for example, that every doctor has an iPhone 8 or a Samsung S9 but nothing else. They can also keep phones more up to date over time to ensure that they have hardware that supports newer network protocols and other capabilities like Bluetooth and near field communication (NFC). Customers who use CYOD are typically on a two- or three-year refresh cycle.

Security risks are also lower with CYOD because the hospital IT organization has confidence that everyone is using more up-to-date devices. They can also ensure that all of these devices have an enterprise mobility management (EMM) agent and other tools installed so they can be managed when connected to the enterprise network and have enterprise-level security.

Sometimes the CYOD vs. BYOD decision comes down to budget: can the hospital afford to buy phones for end users? The added cost of buying phones needs to be weighed against the cost to mitigate the risks of a BYOD model.

Still Not Sure?

Generally speaking, 90% or more of users will find a natural fit with either a Badge or a smartphone. But some may not. If you’re not sure, I suggest having some users in that group try Badges and others try smartphones and see what they prefer.

Another option is what we call “dual mode” where users are simultaneously logged into a Badge and a smartphone. Obviously this can get more expensive but a limited set of users within areas like the ED and NICU might need it.

You Have Choices; Vocera Can Help You

Most smartphone vendors are going to tell you everybody in your hospital needs a smartphone. They want you to buy more of their product. Most software vendors selling smartphone apps are going to tell you the same thing. When all you have is a hammer, everything is a nail.

Vocera is device agnostic. We will support you whether you choose to access our platform using Badges or smartphones – or a mix of the two, which is what the vast majority of customers do. It all depends on your users and the services they need.

Our account managers and clinical executives can help guide you through these decisions, starting by helping you understand your end users and their needs, and letting that guide your device decisions. Know that no matter your choice, we will be there with you.

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Get your free copy of the KLAS report Clinical Mobility 2018 – Leveraging a Smartphone Strategy.